Quality manager health systems administrator

Primary Location : United States of America-OHIO-Franklin County-Columbus

Other Locations : United States of America-OHIO-Franklin County-Columbus

Work Locations : Lazarus 4 50 West Town Street Columbus 43215

Organization : Ohio Department of Medicaid

Classified Indicator : Classified

Bargaining Unit / Exempt : Exempt

Schedule : Full-time

Work Hours : 8:00 am - 5:00 pm

Compensation : $35.74/hour

Unposting Date : Apr 1, 2024, 10:59:00 PM

Primary Job Skill : Health Administration

Technical Skills : Health Administration

Professional Skills : Collaboration, Decision Making, Leading Others, Managing Meetings, Motivating Others, Performance Management, Time Management, Verbal Communication, Written Communication

Agency Contact Name : ODM Human Resources

Agency Contact Information :

HYBRID - Quality Initiatives Manager (Medicaid Health Systems Administrator 1)

(240002RY)

Job Duties

THIS POSITION MAY BE TELEWORK ELIGIBLE ON A HYBRID BASIS.

About Us:

The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. ODM is implementing the next generation of Ohio Medicaid to fulfill its bold, new vision for Ohio’s Medicaid program - focusing on the individual rather than the business of managed care.

The goals of the next generation of Ohio Medicaid are:

• Emphasize a personalized care experience
• Improve care for children and adults with complex behavioral health needs
• Improve wellness and health outcomes
• Support providers in better patient care
• Increase program transparency and accountability

What You Will Do At ODM:

Office : Health Innovation & Quality

Bureau : Health Research & Quality

Classification : Medicaid Health Systems Administrator 1 (PN 20100150)

Job Overview :

The Ohio Department of Medicaid is seeking a healthcare professional to manage outcome improvement initiatives using quality improvement science tools and methods to enhance the quality of health plan services, primarily for the OhioRISE (Resilience through Integrated Systems and Excellence) Plan to improve outcomes and physical and behavioral health integration for a targeted Medicaid population stream (i.e. OhioRISE Healthy Children ). As the Quality Initiatives Manager in the Office of Health Innovation & Quality, your responsibilities will include:

• Collaborating closely with ODM OhioRISE and Data Governance and Analysis staff, as well as with other relevant entities such as sister-state agencies (e.g., Department of Mental Health and Addiction Services-MHAS), MCOs, the SPBM, provider associations, vendors, and other internal and external stakeholders and partners.

• Facilitating collaboration between the OhioRISE Plan and providers (e.g., Care Management Entities), Medicaid Managed Care Organizations (MCOOs), and the Single Pharmacy Benefit Manager (SPBM) to maximize collective impact.

• Oversee the quality improvement initiatives across the OhioRISE Plan and providers (e.g., Care Management Entities) to improve population health.

• Integrating data from multiple data sources (e.g., risk assessments, clinical and academic performance measures, member satisfaction surveys) and using this information to inform improvement.

• Staying up to date in the use of quality improvement science tools and methods and actively using them to assist OhioRISE in improving health outcomes for children with behavioral health needs and ensuring the integration of behavioral and physical health.

• Ensuring that the OhioRISE Plan is engaged in regular weekly testing of improvements to its processes to improve care for members and interactions with providers.

• Tracking project progress and keep your supervisor and ODM team members informed of any barriers, and elevate issues as needed.

• Maintaining a timeline of policy updates, improvement activities, and system changes impacting the behavioral and physical health of the OhioRISE population, including integration of behavioral and physical health.

• Assisting in overall planning for population health improvement activities impacting the physical and behavioral health of OhioRISE children

• Identifying data needed in order to better understand a population stream(s) and any disparities in sub-populations

What’s in it for you:

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

Medical Coverage

• Quality, affordable, and competitive medical benefits are offered through the available Ohio Med plans.

Dental, Vision and Basic Life Insurance

• Dental, vision, and basic life insurance premiums are free after completed eligibility period. Length of eligibility period is dependent on union representation.

Time Away From Work and Work/Life Balance

• Paid time off, including vacation, personal, and sick leave
• 11 paid holidays per year
• Childbirth/Adoption leave

Employee Development Funds

• The State of Ohio offers a variety of educational and professional development funding that varies based on whether you are a union-exempt employee or a union-represented employee.

Ohio Public Employees Retirement System

• OPERS is the retirement system for State of Ohio employees. The employee contributes 10% of their salary towards their retirement. The employer contributes an amount equal to 14% of the employee’s salary. Visit the OPERS website for more information.

Deferred Compensation

• The Ohio Deferred Compensation program is a 457(b) voluntary retirement savings plan. Visit the Ohio Deferred Compensation website for more information.

Qualifications

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis).

• Or 12 months experience has Medicaid Health Systems Specialist, 65293,

• Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure.

Technical Skills: Health Administration

Professional Skills: Collaboration, Decision Making, Leading Others, Managing Meetings, Motivating Others, Performance Management, Time Management, Verbal Communication, Written Communication

ADA Statement

Ohio is a Disability Inclusion State and strives to be a Model Employer of Individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.

Drug-Free Workplace

The State of Ohio is a drug-free Workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

Supplemental Information:

Compensation is as listed on the posting unless required by legislation or union contract.

This position is overtime exempt. Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.

Resumes and/or attachments are not reviewed. Therefore, please provide detail in the work experience section of your application.

Background Check Information

The final candidate selected for this position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration.